Medial unicompartmental arthroplasty after failed high tibial osteotomy

Rees, Jonathan; Price, Andrew; Lynskey, T.; Svärd, U. C. G.; Dodd, Christopher; Murray, David

doi:10.1302/0301-620x.83b7.11827

Cited by 29 publications

(17 citation statements)

References 10 publications

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“…Although Kozinn and Scott recommend a total knee prosthesis when subchondral bone is exposed, Goodfellow et al state that correction of the malalignment relieves the patella from the increased load [15,21]. Rees already demonstrated that a high tibial osteotomy is a contraindication to a medial OUKP [28]. This is supported by our poor results in this specific subgroup.…”

Section: Discussionmentioning

confidence: 59%

The Oxford unicompartmental knee prosthesis: an independent 10-year survival analysis

Vorlat

Putzeys

Cottenie

et al. 2005

Knee Surg Sports Traumatol Arthrosc

101

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One hundred forty-nine medial prostheses were implanted in 140 patients between 1988 and 1996. After a mean of 67 months 28 patients had died, without the need for revision. Seventeen prostheses were lost to follow-up. Revision surgery using a total knee prosthesis was performed in 16 cases. In four others, a lateral prosthesis was implanted subsequently to a medial one. One of these four was revised to a total knee prosthesis 6 years later. In another four cases, late complications of the meniscal bearing were treated with replacement of this bearing. The surviving prostheses were seen back after a mean of 126 months. The cumulative survival rate at 10 years was 82% for the whole population and 84% when knees with a previous high tibial osteotomy were excluded. Since these results compare poorly to the survival of total knee arthroplasty, this prosthesis is not the first-choice implant. Because it preserves a maximum of bone stock and is revised to a total prosthesis almost without difficulty, it is the first-choice implant for medial unicompartmental osteoarthritis in patients younger than 65. Further research is mandatory to confirm that this prosthesis very rarely needs revision in patients older than 75. It should not be used in osteotomized knees.

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Section: Discussionmentioning

confidence: 59%

The Oxford unicompartmental knee prosthesis: an independent 10-year survival analysis

Vorlat

Putzeys

Cottenie

et al. 2005

Knee Surg Sports Traumatol Arthrosc

101

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“…Vorlat et al [50] did not show successful outcome of UKAs after HTO. Likewise, the revision rate after HTO was 28% in Rees’ series [40] after a FU period of 2.9 years. One patient with a previous HTO in this series was revised from UKA to TKA.…”

Section: Discussionmentioning

confidence: 99%

Oxford Phase 3 unicompartmental knee arthroplasty: medium-term results of a minimally invasive surgical procedure

Lisowski

Bekerom

Pilot

et al. 2010

Knee Surg Sports Traumatol Arthrosc

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PurposeIn the last decade, a major increase in the use of and interest in unicompartmental knee arthroplasty (UKA) has developed. The Oxford Phase 3 UKA is implanted with a minimally invasive technique using newly developed instruments. The objective of this prospective study was to evaluate the outcome of UKA in patients with medial osteoarthritis of the knee in a high-volume unit.MethodsTwo-hundred and forty-four UKAs were performed with a minimally invasive approach. The median age was 72 (43–91) years. The median follow-up was 4.2 years (range 1–10.4 years). Fourteen patients died, and nine were considered to be lost to follow-up, but all had a well-functioning prosthesis in situ until their last follow-up. Pain, function and health-related quality of life were evaluated pre- and postoperatively using patient- and assessor-based outcome scores, as well as radiographic evidence.ResultsThe mean Knee Society knee and function scores, WOMAC-scores, Oxford-score and VAS pain and satisfaction all improved. Nine knees required revision. Eleven patients required an additional arthroscopic procedure due to persisting pain secondary to intra-articular pathology, and four patients required manipulation under anaesthesia because of limited range of motion. The 7-year cumulative survival rate of the arthroplasty was 94.4%. A low incidence (21%) of a radiolucent line beneath the tibial component was observed at 5 years of follow-up.ConclusionThis study showed a high survival rate of the Oxford Phase 3 UKA. Patient satisfaction and functional performance were also very high. Major complication rate was low; in addition, the incidence of radiolucency under the tibial component, when compared to present literature, was low. When strict indication criteria are followed, excellent, durable, and in our opinion reliable, results can be expected for this procedure.

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“…However, high failure rates of UKA conversion from HTO have been reported18 because of technical problems associated with ligamentous instability, or lateral wear and subsequent failure. Therefore, we selected a joint preserving surgery as the initial treatment.…”

Section: Discussionmentioning

confidence: 99%

Additional distal femoral osteotomy for insufficient correction after high tibial osteotomy

Nakamura¹,

Kuroda

Takahashi³

et al. 2018

BMJ Case Reports

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A 70-year-old man who was treated with a closed-wedge high tibial osteotomy (HTO) had recurrent right medial knee pain 12 years after the initial osteotomy. We planned a recorrection osteotomy because the patient led an active lifestyle, had well-preserved range of motion and the lateral compartment was still intact. According to preoperative deformity analysis, which indicated a tibia in slight valgus and a femur in moderate varus, recorrection of the distal femur was chosen. Seven degrees of biplanar distal femoral osteotomy (DFO) was performed using a contralateral version of the TomoFix Medial Distal Femur. At 1 year follow-up, the femorotibial angle had improved from 178° to 170°, and the Japanese Orthopaedic Association score had improved from 75 to 95 points. Additional DFO could be a viable alternative for total knee arthroplasty or recorrection HTO when the centre of the deformity is located at the distal femur.

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Medial unicompartmental arthroplasty after failed high tibial osteotomy

Cited by 29 publications

References 10 publications

The Oxford unicompartmental knee prosthesis: an independent 10-year survival analysis

The Oxford unicompartmental knee prosthesis: an independent 10-year survival analysis

Oxford Phase 3 unicompartmental knee arthroplasty: medium-term results of a minimally invasive surgical procedure

Additional distal femoral osteotomy for insufficient correction after high tibial osteotomy

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